Successful treatment of pure red cell aplasia after major ABO-incompatible T cell-depleted bone marrow transplantation with erythropoietin.
A 40-year-old woman with acute myeloid leukemia in first remission developed pure red cell aplasia after a T cell-depleted ABO-incompatible bone marrow transplant from her HLA-identical sister. She remained transfusion-dependent for 11 months despite conversion of the ABO blood group to donor type, and titers of anti-donor isohemagglutinin being undetectable. Treatment with erythropoietin resulted in rapid improvement of the anemia with no further need for transfusions up to 21 months post-transplant. This case suggests that erythropoietin may provide effective therapy for pure red cell aplasia after ABO-incompatible bone marrow transplantation without the additional risks of further immunosuppression.
Santamaría
A
A
Departament d'Hematologia, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
Sureda
A
A
Martino
R
R
Domingo-Albós
A
A
Muñiz-Díaz
E
E
Brunet
S
S
D000017:ABO Blood-Group System / Q000276:immunology*; D000328:Adult; D001787:Blood Group Incompatibility / Q000150:complications*; D016026:Bone Marrow Transplantation / Q000276:immunology; D004921:Erythropoietin / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D015479:Leukemia, Myelomonocytic, Acute / Q000628:therapy; D008212:Lymphocyte Depletion; D012010:Red-Cell Aplasia, Pure / Q000209:etiology / Q000628:therapy*; D013601:T-Lymphocytes; D014184:Transplantation, Homologous
D000017:ABO Blood-Group System; D004921:Erythropoietin